Authorization to Disseminate and Utilize Information and Waiver of Remuneration and of Liability

AUTHORIZATION TO DISSEMINATE AND UTILIZE INFORMATION AND WAIVER OF REMUNERATION AND OF LIABILITY 2016-2017

I hereby grant Our Lady of Fatima Elementary Schoolthe right to obtain, disseminate and utilize the following listed information pertaining to my child/children, , and , without cost, remuneration, royalty fee or expense, on its web site, and without further notice:

1. Photographic images, video images or similar technology which may effect a visual representation of my child/children including candid images (ex. mini mall, breakfast with principal, etc.) taken during school hours and at school functions;

1. Audio or digitally reproduced, taped and other vocal reproductions and representations of my child/children’s voice;

1. Honor roll lists containing my child/children’s name in conjunction therewith;

1. Citizenship, religious and other awards received by my child/children as judged appropriate for inclusion in the sole discretion of the school;

1. Samples of my child/children’s work (ex. art, essays, etc.);

1. The school newsletter with any references made to my child/children or his/her class activities;

1. Student phone numbers and addresses given to room parents and parents of classmates in order to organize school projects, birthday parties and other events.

I understand that no photographic or visual reproduction of my child appearing on the school’s website/homepage will identify my child/children by name. I understand that all images, reproductions, content or other information which is hereby authorized to be utilized shall become the property of the school, to be used as deemed appropriate in its sole discretion, without royalty payments, fees or remuneration of any kind.

Further, I waive and release any claims for damages or liability against the school, its related parishes or the Catholic Diocese of Biloxi, which I may now have or may have in the future, arising out of or in any way connected with the reproduction, use and dissemination of the above authorized information on my child/children upon the aforementioned website/homepage.

Parent/Guardian Date

Wavier of Liability | 1